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Introduction: Children with Special Healthcare Needs (CSHCN) are considered difficult to maintain oral hygiene and challenging for caregivers and dentists to attain cooperation in dental treatment under general anaesthesia. Family Impact Scale (FIS) and Parental-Caregiver Perceptions Questionnaire (P-CPQ) are useful tools to assess patient’s oral health quality of life and caregivers perception. Aim: To assess the impact of dental treatment under general anaesthesia on the quality of life and oral hygiene of CSHCNs, as perceived by caregivers. Materials and Methods: This prospective follow-up survey study was carried out at Dammam Medical Complex, Saudi Arabia, from December 5th, 2019 to December 15th, 2021. The CSHCN of either gender, aged 12 years, and falling within the American Academy of Pediatric Dentistry (AAPD) definition of special-needs patients referred for invasive procedures under general anaesthesia (American Society of Anaesthesiologists (ASA) class I or II), were included. The baseline and, after a one-year follow-up, information obtained from two surveys that were altered from Thompson’s P-CPQ and FIS were decoded into the numeric ordinal scales Never (“0”), Once or Twice (“1”), Sometime (“2”), Always (“3”), and Daily (“4”). Analysis of the collected data was done by Statistical Package for Social Sciences (SPSS) version 20.0. Results: A total of 84 participants were caregivers of CSHCN who underwent dental procedures under General Anaesthesia (GA), of whom 77 (91.7%) were mothers and 7 (8.3%) were fathers of the CSHCN. The mean age of children was 8.29±2.14 years (Range= 3-12 years); 38 (45.2%) were males and 46 (54.8%) were females. The median FIS after treatment was zero, compared to the median before treatment which was 2, revealing a significant impact on being absent from work, a child requiring more care, the impact of presence, sleeping disturbances, feeling angry, feeling guilty, and a child disputing or blaming either parent (p

Spiny-like spherical copper metal–organic frameworks (SSC-MOFs) were prepared and characterized via SEM, TEM, EDS, XRD, FTIR and the BET surface area. The fabricated SSC-MOFs were applied to develop a procedure for the microextraction of trace arsenic(III) for preconcentration. The results show that a copper- and imidazole-derived metal–organic framework was formed in a sphere with a spiny surface and a surface area of 120.7 m2/g. The TEM confirmed the perforated network structures of the SSC-MOFs, which were prepared at room temperature. The surface functional groups were found to contain NH and C=N groups. The XRD analysis confirmed the crystalline structure of the prepared SSC-MOFs. The application for the process of microextracting the arsenic(III) for preconcentration was achieved with superior efficiency. The optimum conditions for the recovery of the arsenic(III) were a pH of 7 and the use of a sample volume up to 40 mL. The developed SSC-MOF-derived microextraction process has an LOD of 0.554 µg·L−1 and an LOQ of 1.66 µg·L−10. The developed SSC-MOF-derived microextraction process was applied for the accurate preconcentration of arsenic(III) from real samples, including food and water, with the promised performance efficiency.

Abstract Background 20–80% of adults presenting to a dental clinic experience anxiety. Negative past dental experiences and environmental factors such as the waiting area of a dental clinic or sound of a drill are commonly considered triggering factors for anxiety. Anxiety management strategies are considered a part of routine dental procedure, due to increased prevalence and compromised patient care. Hence the aim of the present study is to identify the prevalence and variables associated with dental anxiety and their management in patients visiting the primary care dental clinics in Bahrain. Method Four hundred and eighty participants were included. A 3-part questionnaire deciphered the demographic characteristics of the participants, the dental procedure undertaken, the level of anxiety, and the management strategy used by the dentist. The pre and post-treatment MDAS scores were recorded. Paired t test, ANOVA and Wilcoxon signed rank test was used to test the level of significance between the variables and the mean MDAS scores. The p ≤ 0.05 was considered statistically significant. Results The prevalence of dental anxiety was 23.7% with moderate anxiety, and 11.4% with high anxiety. Females presented with a higher mean MDAS both pre and post-treatment compared with males. A statistically significant difference between the pre and post-treatment MDAS scores were observed in educated patients less than 50 years of age. Those with unpleasant previous dental experience showed statistically significant difference. Analyses of anxiety management techniques showed that single techniques worked better than combination techniques. Rest and breaks combined with any other technique of choice showed significant reduction in the MDAS scores post treatment. Conclusion To conclude, all patients attending the dental clinic present with some level of anxiety that necessitates the dentist to use anxiety management strategies. Non-pharmacological methods that are non-invasive must be the first choice. Rests and breaks, with any technique of choice provides the best possible anxiety management. It is possible to achieve the desired anxiety reduction in single visit to complete the planned dental intervention, other than in patients who are dental phobic.

Objective: To evaluate the effectiveness of an educational intervention to improve the knowledge regarding ventilator-associated pneumonia (VAP) and practices of VAP prevention bundle among the intensive care unit (ICU) nurses in Salmaniya Medical Complex in Bahrain. Methods: A quasi- experimental study was conducted in the main ICU of Salmaniya Medical Complex in Bahrain from October 2021 to January 2022. A convenience sampling technique was used, and 58 ICU staff nurses were enrolled in the study. Tools used for data collection were a self-administered questionnaire to assess ICU nurses knowledge and an observational checklist to assess the adherence of ICU nurses to the VAP prevention bundle. Results: Of 58 total study subjects, almost three-quarters of the ICU nurses 42 (72%) had poor knowledge of VAP prior to the educational intervention. However, after the implementation, the proportion increased with 46 (79%) of the nurses acquiring good knowledge about the VAP and 56 (97%) of the ICU nurses acquiring good knowledge of the VAP prevention bundle. Overall, there was a significant improvement in the median score of adherences to the VAP prevention bundle elements before and after the intervention (p-value ≤ 0.05). Conclusion: This study concluded that the levels of knowledge about VAP and practices of the VAP prevention bundle can be improved by implementing a relevant educational program for ICU nurses. The findings of this study also provide evidence of the importance of a continuous training program for ICU nurses to ensure quality patient care in the critical care units.

Veno-arterial extracorporeal membrane oxygenation is used in patients requiring biventricular support; however, its use increases the afterload. In patients with severe aortic insufficiency or severe left ventricular disfunction, it will increase left-side filling pressures, hence the need for left ventricle unloading with an additional mechanical circulatory support device. We present a case of a patient with cardiogenic shock and severe aortic insufficiency who underwent left atrial veno-arterial extracorporeal membrane oxygenation and provide a step-by-step explanation of the technique.

BACKGROUND: Chronic subdural hematoma (CSDH) has significant patient morbidity and recurrence that drives the management towards less invasive procedures. We describe the different indications of middle meningeal artery embolization (MME) in management of CSDH. OBJECTIVE: We aimed to report and evaluate our institutional experience using MME in management of CSDH. PATIENTS AND METHODS: Retrospective analysis was conducted between 2020 and 2023, we reviewed the different indications of MME using different embolization material. Clinical and radiological outcomes were described 6 months and 1 year postoperatively. RESULTS: Twenty one CSDHs were treated in 16 patients (5 patients had bilateral CSDH). In patients with bilateral CSDH each hematoma was considered separately. Of the 21 hematomas, 7 (33.3%) were treated upfront without prior surgical treatment, 4 (19.1%) were treated for recurrence after prior surgical evacuation, and 10 (47.6%) were treated prophylactically following surgical evacuation. Post embolization, one hematoma needed to be evacuated due to failure of hematoma volume reduction. By the end of one year follow up, 50% reduction in hematoma size was achieved in 13 hematomas (62%), while total disappearance was evident in 7 hematomas (33.3%). Recurrence was noted in one patient on renal dialysis which was managed conservatively. The modified Rankin scale (mRS) improved after 6 months in comparison to the admission time from 3 ± 1.2 to 1.6 ± 0.63 with p value of 0.003. CONCLUSION: The MME is a safe and effective technique that should be considered in management of CSDH in patients with multiple morbidities and patients who have high risk of recurrence. [ABSTRACT FROM AUTHOR]